[特纳综合征女性的复制和生化老化机制]。

R K Mikheev, E N Andreeva, O R Grigoryan, E V Sheremetyeva, M S Pankratova, E V Loginova
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引用次数: 0

摘要

背景:2025 年是首次对特纳综合征进行历史性描述的 100 周年纪念,特纳综合征是由基因组异常、先天性性腺发育障碍和性腺功能减退组成的综合征。雌激素完全缺乏会引发与年龄相关的并发症。目的:评估特纳综合征女性患者的复制标志物(端粒长度)和生化标志物(血脂、磷酸钙、甲状腺激素、细胞溶解和胆汁淤积标志物、碳水化合物代谢、氮代谢、电解质、前列腺素)的特征:自 2021 年 1 月 10 日至 2022 年 8 月 1 日,俄罗斯卫生部内分泌学研究中心与莫斯科国立罗蒙诺索夫大学医学研究与教育中心合作开展了此项研究。特纳综合征(45,X0;45,X/46,XX;45,X/46,X,r(X);13-40 岁;n=26)和原发性卵巢功能不全(18-39 нyears=26)引起的非性腺功能亢进性性腺功能减退症女性;育龄健康女性(15-49 岁;n=24)。患者均接受了实验室遗传(白细胞端粒长度)、生化(空腹血糖、尿素、肌酐、普通/结合胆红素、谷丙转氨酶、谷草转氨酶、γ-谷氨酰转移酶、甘油三酯、高密度脂蛋白-P、低密度脂蛋白-P、普通胆固醇、普通/离子化钙、磷酸盐、维生素 D、钠/钾/氯化物、前列腺素、HbA1c)分析。身体测量 - 体重、身高。DNA 提取--使用 Qiagen DNA 血液迷你试剂盒(德国)。白细胞端粒长度--使用实时聚合酶链反应 PCR(Flow-fish)。软件程序 IBM SPSS Statistics(Windows 26.0 版):1.特纳综合征女性的平均端粒长度(8,22 kB [6,63-9,30] )明显低于原发性卵巢功能不全女性(10, 34 кБ [8,41-13,08], p<0,001)和健康育龄女性(10,77 kB [9,95-13,16], р>0,05)。2. 端粒长度与原发性卵巢功能不全女性更年期激素治疗的寿命直接且显著相关(ρ = 505; p<0,001)。 3. 特纳综合征患者倾向于维生素 D 缺乏(р<0,001)、血脂异常(р=0,01);转氨酶、胆汁淤积标志物、磷酸盐和 FSH 水平升高(р<0,001):特纳综合征是一种严重的遗传疾病,不仅会导致不孕不育,还会显著降低 "健康老龄化 "受孕的质量/寿命。
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[Replicative and biochemical ageing mechanisms among females with Turner syndromes].

Background: 2025 is going to be the 100th anniversary of the first historical description of Turner syndrome - complex of  genomic abnormalities, congenital gonadal disruption and hypergonadotropic hypogonadism. Total estrogenic deficiency triggers development of age-related comorbidities. There is no doubt that personalized search for replicative markers of cellular aging among females with Turner syndrome is needed.

Aim: To evaluate features of replicative (telomere length) and biochemical (lipid profile, calcium-phosphate album, thyroid hormones, markers cytolysis and cholestasis, carbohydrate metabolism, nitrogenic metabolism, electrolytes, FSH) markers among females with Turner syndrome.

Materials and methods: Research has been provided in collaboration between Endocrinology Research Centre of the Russian Ministry of Health and Lomonosov Moscow State University Medical Research and Educational Centre in the period since 10.01.2021 until 01.08.2022. Females with non-iatrogenic hypergonadotropic hypogonadism caused by Turner syndrome (45,X0; 45,X/46,XX; 45,X/46,X,r(X); 13-40 y.o.; n=26) and primary ovarian insufficiency (18-39 нyears=26); healthy females of reproductive age (15-49 y.o.; n=24). Patients have undergone laboratory genetic (leucocyte telomere length), biochemical (fasting glycaemia, urea, creatinine, common/conjugated bilirubin, ALT, AST, gamma-glutamyl transferase, triglycerides, HDL-P, LDL-P, common cholesterol, common/ionized calcium, phosphate, vitamin D, sodium/potassium/chlorides, FSH, HbA1c) analyses. Body measurements - body mass, body height. DNA extraction - provided with Qiagen DNA blood mini kit (Germany). Leukocyte telomere length - with real-time polymerase chain reaction PCR (Flow-fish). Soft program IBM SPSS Statistics (version 26,0 for Windows).

Results: 1. Females with Turner syndrome have significantly lower mean telomere length (8,22 kB [6,63-9,30]) than with primary ovarian insufficiency (10, 34 кБ [8,41-13,08], p<0,001) and healthy reproductive age females (10,77 kB [9,95-13,16], р>0,05).2. Telomere length correlates directly and significantly with longevity of menopausal hormonal therapy among females with primary ovarian insufficiency (ρ = 505; p<0,001).3. Patients with Turner syndrome are inclined to vitamin D deficiency (р<0,001), dyslipidemia (р=0,01); increase of levels of aminotransferases, cholestasis markers, phosphate and FSH (р<0,001).

Conclusion: Turner syndrome is serious genetic disease that leads not only to infertility but to significant decrease of quality/life longevity out of "healthy aging" conception.

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